Glaucoma following congenital cataract surgery: An 18-year longitudinal follow-up

Objective. The purpose of this study was to study the imaging features of ultrasound biomicroscopy (UBM) in the aphakia with visual axis opacification (VAO) after congenital cataract surgery. Methods. From May 2015 to May 2018, aphakia patients with VAO who underwent congenital cataract surgery were examined by high-resolution bag/balloon UBM technique, and the results of UBM imaging were analyzed. According to UBM imaging features, different types of VAO were classified. Results. A total of 38 children (55 eyes) with VAO were included. 17 patients were bilateral, and 21 patients were unilateral. Patients with VAO were classified into 3 groups according to the UBM imaging features: membranous fibrosis VOA (17 cases, 28 eyes), cortical regeneration VOA (15 cases, 20 eyes), and mixed VOA (6 cases, 7 eyes). The patients in the membranous fibrosis group underwent Nd:YAG laser posterior capsulotomy, those in the cortical regeneration group underwent anterior vitrectomy, and those in the mixed type group underwent anterior vitrectomy with RF capsulotomy tip. After surgery, VAO were removed in all patients. During the follow-up period, in the membranous fibrotic VAO group, iris adhesion and pupillary occlusion were found in 2 eyes, and anterior vitrectomy combined with separation of iris adhesion was performed. In cortical regenerative and mixed type VAO groups, anterior vitrectomy was performed without opacity in the axial region. The total recurrence rate of VAO was 3.46%. Conclusion. After congenital cataract surgery, the UBM imaging features of aphakia with VAO are helpful to evaluate the condition of VAO before reoperation so as to choose the optimal surgical method to achieve better therapeutic effect.

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Effect of Timing of Initial Cataract Surgery, Compliance to Amblyopia Therapy on Outcomes of Secondary Intraocular Lens Implantation in Chinese Children: A Retrospective Case Series

Journal of Ophthalmology ◽

10.1155/2018/2909024 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Liuyang Li ◽

Yan Wang ◽

Caihong Xue

Keyword(s):

Cataract Surgery ◽

Congenital Cataract ◽

Visual Outcome ◽

Cataract Extraction ◽

Extraction Time ◽

Good Compliance ◽

Iol Implantation ◽

Secondary Iol Implantation ◽

Congenital Cataract Surgery

Purpose. As a secondary analysis, we reassess the association of initial congenital cataract surgery times, compliance to amblyopia therapy, and visual outcomes for a long-term follow-up in a secondary IOL implantation. Methods. Retrospective review of records of all infants with congenital cataracts who underwent secondary IOL implantation in the Eye and ENT Hospital of Fudan University from January 1, 2001, to December 31, 2007, and the minimum follow-up period was 5 years. Multiple regression analysis was used and the possible confounding factors were also analyzed to assess the effect on visual outcome. Results. A total of 110 patients (male: 59.1%) were included. The median (min–max) age at cataract extraction and IOL implantation was 7.5 (3.0–15.0) and 35.0 (22.0–184.0) months, respectively, and the average follow-up period was 99.3 ± 23.6 months. The median (min–max) BCVA at final follow-up was 0.20 (0.01–1.00). Compliance to amblyopia therapy was none, poor, and good in 21.8%, 24.5%, and 53.6%, respectively. Postoperative BCVA [logMAR, median (min–max) 0.70 (0.00–2.00)] linearly decreased with increasing cataract extraction time (per month) (β=0.04, 95% CI: 0.03–0.06, p<0.0001) in multivariable models with laterality and compliance to amblyopia therapy adjusted. Good compliance to amblyopia therapy was associated with better BCVA (logMAR) at last follow-up (β=−0.40, 95% CI = −0.53 to −0.27, p<0.0001) with laterality, opacity type, and extraction time adjusted. Conclusions. For Chinese infants with congenital cataract, an earlier primary congenital cataract surgery at an age of 3 to 15 months is associated with a better visual outcome. Good compliance to amblyopia therapy was also significant to visual outcome.

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The effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4–8 years

BMC Ophthalmology ◽

10.1186/s12886-021-02098-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jing Shang Zhang ◽

Jin Da Wang ◽

Mayinuer Yusufu ◽

Kai Cao ◽

Shan Shan Jin ◽

...

Keyword(s):

Cataract Surgery ◽

Nd:Yag Laser ◽

Congenital Cataract ◽

Posterior Capsule ◽

Visual Axis ◽

Lens Implantation ◽

Group A ◽

Group B ◽

Congenital Cataract Surgery

Abstract Background The present study sought to observe the effect of retaining intact posterior capsule in congenital cataract surgery in children aged 4–8 years. Methods This is a retrospective case control study. Seventy-seven children (130 eyes) aged from 4 to 8 years who underwent cataract surgery were divided into two groups. In Group A, 50 eyes underwent phacoemulsification, intraocular lens implantation and posterior capsule capsulotomy combined with anterior vitrectomy. In Group B, 80 eyes underwent cataract phacoemulsification and intraocular lens implantation. The postoperative visual acuity and the rate of complications were compared. Results In all patients, cataract surgeries were performed evenly without intraoperative complications. The follow-up time ranged from 6 months to 42 months. No apparent visual axis opacity was detected in group A during the follow-up. By the last visit, apparent visual axis opacity was detected in 31 eyes (38.75%) in group B. Among them, 9 eyes (29.03%) with mild posterior capsule opacification (PCO) were treated with Nd:YAG laser, 3 eyes (9.68%) with thick proliferative membranes were treated with posterior capsule capsulotomy combined with anterior vitrectomy and proliferative membranes in 19 eyes (61.29%) were completely aspired and the posterior capsule was retained. During follow-up, only 2 (6.45%) eyes had PCO recurrence and were treated with Nd:YAG laser. The visual acuity was significantly higher than that before surgery in all patients. Conclusions For older children, the incidence of PCO will be low even if intact posterior capsule is retained. Either Nd:YAG laser or surgical treatment for PCO will be able to maintain good vision.

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Timing of Congenital Cataract Surgery from Different Aspects

Advances in Ophthalmology & Visual System ◽

10.15406/aovs.2016.05.00148 ◽

2016 ◽

Vol 5 (2) ◽

Author(s):

Ozlem Ural Fatihoglu

Keyword(s):

Cataract Surgery ◽

Congenital Cataract ◽

Congenital Cataract Surgery

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Clinical characteristics and treatment of secondary glaucoma, glaucoma suspects and ocular hypertension after congenital cataract surgery

European Journal of Ophthalmology ◽

10.1177/1120672121991356 ◽

2021 ◽

pp. 112067212199135

Author(s):

Katharina Eibenberger ◽

Barbara Kiss ◽

Ursula Schmidt-Erfurth ◽

Eva Stifter

Keyword(s):

Intraocular Pressure ◽

Cataract Surgery ◽

Ocular Hypertension ◽

Congenital Cataract ◽

Case Series ◽

Secondary Glaucoma ◽

Visual Axis ◽

Retrospective Case ◽

Pediatric Cataract ◽

Congenital Cataract Surgery

Objective: To evaluate changes in intraocular pressure after congenital cataract surgery in a real-world setting. Methods: This retrospective case series included all children aged 0–2 years undergoing lens extraction due to congenital cataract. Development of an elevated intraocular pressure was divided into three groups: secG, suspG and OHT. Further, risk factors for IOP changes, the therapeutic approach and functional outcome were assessed during follow-up. Results: One hundred and sixty-one eyes of 110 patients aged 0–2 years were included, whereof 29 eyes of 17 children developed secondary glaucoma (secG; 11 eyes/8 patients), glaucoma suspect (suspG; three eyes/three patients) or ocular hypertension (OHT; 15 eyes/10 patients). No difference in surgrical procedure ( p = 0.62) was found, but age at cataract surgery differed significantly ( p = 0.048), with the secG group (1.74 ± 1.01 months) being the youngest (suspG: 3.93 ± 1.80 months; OHT group: 5.91 ± 5.36 months). Secondary surgical intervention was significantly higher in the secG (4.64 ± 3.41) followed by the suspG (2.00 ± 2.65) and OHT groups (0.40 ± 0.74; p < 0.001). Postoperative complications including nystagmus ( p = 0.81), strabismus ( p = 0.98) and amblyopia ( p = 0.73) showed no difference, in contrast to visual axis obscuration which was more common in the secG group ( p = 0.036). Conclusion: Initial lensectomy and anterior vitrectomy procedure together with or without IOL implantation seems to have no influence for the development of IOP changes after pediatric cataract surgery. However, children who developed secondary glaucoma had cataract surgery significantly earlier, within the first 2–3 months of life. Glaucoma surgery was required to achieve final IOP control in most eyes. The development of secondary glaucoma was also associated with a significant increase in surgical re-treatments.

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